Facing life-prolonging treatment: The perspectives of men with advanced metastatic prostate cancer - An interview study

Sandra Doveson; Maja Holm; Lena Axelsson; Per Fransson; Agneta Wennman-Larsen

doi:10.1016/j.ejon.2020.101859

Facing life-prolonging treatment: The perspectives of men with advanced metastatic prostate cancer - An interview study

Eur J Oncol Nurs. 2020 Dec:49:101859. doi: 10.1016/j.ejon.2020.101859. Epub 2020 Oct 16.

Authors

Sandra Doveson¹, Maja Holm², Lena Axelsson³, Per Fransson⁴, Agneta Wennman-Larsen⁵

Affiliations

¹ Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, SE-171 77 Stockholm, Sweden; Department of Nursing Science, Sophiahemmet University, PO Box 5605, Lindstedtsvägen 8, SE-114 86 Stockholm, Sweden. Electronic address: sandra.doveson@shh.se.
² Department of Nursing Science, Sophiahemmet University, PO Box 5605, Lindstedtsvägen 8, SE-114 86 Stockholm, Sweden; Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stigbergsgatan 30, SE-116 28 Stockholm, Sweden. Electronic address: maja.holm@shh.se.
³ Department of Nursing Science, Sophiahemmet University, PO Box 5605, Lindstedtsvägen 8, SE-114 86 Stockholm, Sweden. Electronic address: lena.axelsson@shh.se.
⁴ Department of Nursing, Umeå University, SE- 901 87 Umeå, Sweden; Cancercentrum, Norrlands University Hospital, SE-901 85 Umeå, Sweden. Electronic address: per.m.fransson@umu.se.
⁵ Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, SE-171 77 Stockholm, Sweden; Department of Nursing Science, Sophiahemmet University, PO Box 5605, Lindstedtsvägen 8, SE-114 86 Stockholm, Sweden. Electronic address: agneta.wennman-larsen@shh.se.

PMID: 33126157
DOI: 10.1016/j.ejon.2020.101859

Abstract

Purpose: Several life-prolonging treatment options have recently become available for metastatic castration-resistant prostate cancer. However, research regarding patient experiences while undergoing these treatments is scarce. The aim was to explore the perspectives of men when facing life-prolonging treatment of metastatic castration-resistant prostate cancer.

Method: Qualitative interviews were conducted with 16 men as they were starting, undergoing or had completed their first life-prolonging treatment. Interpretive description was used for analysis.

Results: The results illuminate the complexity of facing life-prolonging treatment, with interlaced dimensions beyond just the outcome, and where the men described other dimensions of their lives in relation to the treatment. The results are presented as 4 themes; Considering treatment when the remainder of life is at stake, Preparing for the life-prolonging treatment after deciding to go through with it, Considering the prospect of the life-prolonging treatment not being successful and Reflecting on death and dying in the light of a life-limiting illness.

Conclusions: The quality and content of the remainder of life are central for men when facing life-prolonging treatment of metastatic castration-resistant prostate cancer. This is important when weighing desired treatment outcomes against side effects, and when reflecting upon whether going through with treatment would be worth it or not. The results illuminate the importance of encouraging men at this stage to express expectations, hopes and fears regarding the treatment and the future when considering life-prolonging treatments. Nurses working with these patients are important in the decision-making process and in evaluating treatments, to detect needs for interventions.

Keywords: Castration-resistant; Nurse-patient relations; Nursing; Oncology nursing; Palliative care; Patient-centered care; Prostatic neoplasms; Quality of life; Therapeutics.

MeSH terms

Aged
Aged, 80 and over
Continuity of Patient Care*
Humans
Male
Middle Aged
Neoplasm Metastasis / therapy*
Oncology Nursing*
Patient-Centered Care*
Prostatic Neoplasms, Castration-Resistant / nursing*
Prostatic Neoplasms, Castration-Resistant / psychology*
Quality of Life / psychology*
Sweden
Treatment Outcome